Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)

1990-472X

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

10950

10.18499/1990-472X-2025-26-2-102-112

Dynamic electronic auscultation of the lungs in the diagnosis of exercise-induced bronchial asthma (real-time mode)

Glotov

Sergei Ivanovich

PhD, Associate Professor, Associate Professor of the Department of Faculty Therapy named after Prof. V.Ya. Garmashsergeyglot@mail.ruUryasev

Oleg Mikhailovich

Doctor of Medical Sciences, Professor, Head of the Department of Faculty Therapy named after Professor V.Ya. Garmashuryasev08@yandex.ruPonomareva

Irina Borisovna

PhD, Associate Professor, Associate Professor of the Department of Faculty Therapy named after Prof. V.Ya. Garmashdocib@yandex.ruBelsky

Edward Sergeevich

PhD, Associate Professor, Associate Professor of the Department of Faculty Therapy named after Prof. V.Ya. Garmashed.bels@yandex.ruKorshunova

Ludmila Vladimirovna

PhD, Associate Professor, Associate Professor of the Department of Faculty Therapy named after Prof. V.Ya. Garmashpost_luda@mail.ru

Ryazan State Medical University of the Ministry of Health of the Russian Federation

10112025

262102112

03072025

2025

Asthma is a heterogeneous disease. One of the non-allergic phenotypes is exercise-induced asthma, which can aggravate the course of asthma, requiring enhanced therapy. Diagnosis of exercise-induced asthma is difficult due to underestimation of symptoms - wheezing appears only during physical exertion. A promising direction in the diagnostics of exercise-induced asthma is dynamic electronic auscultation of wheezing during bronchoprovocation tests. Objective of the study: to evaluate the capabilities of dynamic electronic auscultation in real time in the diagnosis of exercise-induced asthma in patients with an established diagnosis of asthma during a test with physical exertion. Material and methods. The prospective, observational experimental clinical study included 42 outpatients with suspected exercise-induced asthma (32 mild and 10 moderate BA). Computer spirometry was performed using a Vitalograph ALPHA spirometer (England). Dynamic electronic auscultation of the lungs was performed using our own developed technique during and after physical activity. The resulting audio files were subjected to computer analysis. Results. Registration of respiratory sounds during physical activity and after the test was successfully performed in all 42 patients. Wheezing rales were recorded during physical activity in 11 patients, of which wheezing resumed in 7 patients at 8-14 minutes of the recovery period - 9,8 (7,1; 13,2) min. In 5 patients, the dynamics of the auscultatory picture corresponded to bronchoobstruction - a decrease in FEV1 by 17% or more, in 2 patients, despite the appearance of dry wheezing during physical exertion, clinically significant dynamics of external respiration function were not noted - a decrease in FEV1 by 0.16 0.04 l (by 3.4 0.25%). In 5 patients, there were no wheezing during physical exertion, but in the recovery period at 5-8 minutes - 6,3 (5,3; 7,7) min. Wheezing with a corresponding decrease in FEV1 by 17% or more was recorded. Exercise-induced asthma was diagnosed in 12 of 42 asthma patients (28%). A direct strong correlation was observed between the occurrence of wheezing and obstructive changes in the function of external respiration (r= 0.76, p˂0.05). Conclusion. Dynamic electronic auscultation in real time has proven to be a highly sensitive method that allows reliable recording of the occurrence of wheezing both during the exercise test and in the recovery period in patients with bronchial asthma. This method allows specifying the time intervals of occurrence and disappearance of wheezing and can be used remotely.

asthma, exercise-induced asthma, dynamic electronic auscultation of the lungs, computer spirometry, exercise test

динамическая электронная аускультация легких, компьютерная спирометрия, тест с физической нагрузкой.

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